Lumpectomy v mastectomy

Hi all, I am 55 and have just been diagnosed with stage 2 grade 3 invasive ER+ HER negative breast cancer and have to choose between lumpectomy or mastectomy with or without reconstruction. The lymph nodes also have to be removed. Really struggling with deciding and wondered if any of you lovely ladies have any wise words for me please??!! 

Hi lynnie19,

Thank you for your post.

I’m sorry that you haven’t had any response yet. I am hoping my response will help our members to see your post and share their experience and advice.

In the meantime, please remember that for any clinical questions, our nurses are here and always happy to talk things through.

Sending you our best wishes,

Zoe

Hi @lynnie19  

So sorry you’re here, plus haven’t yet had much response.

I must apologise for my very lengthy reply upfront, sorry.

So haard isn’t it. Having to deal with the diagnosis alone, without having to decide on surgery options.

Have you been told whether you’ll require radiotherapy and chemo, whatever surgery options you decide??

Lumpectomy is obviously less surgery and therefore a quicker recovery. With the possibiilty of lipo filling later, if required.

Mastectomy without recon is very much dependent on how you think you’re going to “feel” without anything physically there. Going flat or with a prosthesis in your bra.  So is a very personal one. But I would think, with the option of recon later, should you not be happy with and wished.

Mast and immed recon, with self tissue, a much longer op, and healing time/increased possible risks of infection, but many women on here have had it, and happy with the results, whichever area of body chosen, tummy, back etc. Or Mast with immed “implant” recon, no scarring to the rest of your body as with self tisuue options and therefore also less risk of infection and quicker recovery/healing time. 

You’ve probably already been through all these options in your mind and maybe still weighing up the various pros and cons??

Me? Both masts and full ANC, 2006 and 07. Wanted immed recon with both, because I knew I wouldn’t be happy without. Was 46 and still single. It Didn’t happen due to change from my initial surgeon retiring, and various miscommunications with the new surgeon, over me only ever wanting “implants” over “self tissue” recon, which was his “forte”, so to speak. Ended up going without any recon and very unhappy, but with the option to take up my desire for implant recon later.

Other “life” brown stuff happened after, e.g. death of all 3 family and other such trauma’s, so it ended up being early 2014 (7yrs later!), when I finally got around to implant recon. And it’s a looong process when it’s from a flat and delayed perspective. Takes approx a year, from initial expanders installation op, successive inflations, op to then install permanent silicons, then nipple recon op, and later icing on the “boob” of areolar tattooing.

Fell off the horse after completed all the inflation appointments, now late 2014, due to other life s**t happening.

I’m basically telling you all of this, because I soo wished I’d pushed for immed implant recon, and got it all over and done with from the early beginnings. Those were my thoughts and feelings from the off.

I’ve often said this on here, when other women are offered mastectomy with ref to choosing “immed recon”, over NOT doing. Personally? “I” would take the immediate recon option EVERY time, as you never know what else is gonna crop up life wise, that’s going to get in the way, if you delay it. 

And why my looong post. Am just speaking from my own personal experience and heart to you. And many others are happy to go without recon. I greatly applaud them. Much depends on how you feel about yourself, personally, whether happy to be without boobs, have a partner/husband and in a happy, long term relationship, where it may not matter so much? All of that sort of thing.

I hope you’re happy with your decision, whatever you choose, Lynnie, and I wish you a speedy recovery, and to be healthy and happy.

Much love and strength to you, flower, Delly xXx     

Hello Lynnie

I don’t feel I have any wise words as each decision is so very personal.

I had two lumpectomies.  One breast was possibility for mastectomy but I felt the less surgery was for me the better option and I didn’t want to lose my breast unless absolutely necessary.

Everyone of us has different perspectives, thoughts and feelings.  Wishing you all the best in reaching the decision that’s best for you!  Big hugs!

Hi,

I got a 2nd opinion as was going to see a surgeon re immediate reconstruction. Ended up having a lift basically and was back at work after just over 3 weeks and it was a much shorter op. I would have a lumpectomy but I guess it depends if you would worry about it coming back but I think it is the same with rads. Maybe double check re that. I don’t regret my decisipn 3 years ago but wonder if I did the right thing. I have my boob still and had the other lifted too. Anyway good luck with your decision.x

Hello 

I have grade 2 dcis I think I’d be inclined to go for a mastectomy with reconstruction just to make sure it didn’t come back but you need to do you, what does your gut say? Can you ask your surgeon/nurse what they would do in your shoes? 

Charlie xx

Hiya

i’m not sure I can offer any meaningful advice but I can tell you my thoughts
I was diagnosed with ILC on 20/08.I was told that it was 2.5cm and was only offered a lumpectomy with sentinel node biopsy although I did ask about a mastectomy I was totally dismissed but when the results came back there were no clear margins so I was then booked in for a mastectomy.

8 days on from the mastectomy I have  today been told that it was a good job that I had a mastectomy as it turned out to be multi focal and they would have never known.It did not show up on any scans.

Right now I’m thanking my lucky stars.

In my opinion a lumpectomy is a much easier surgery to recover from physically and psychologically.As I had originally requested a mastectomy I was not prepared for the mental health impact of having one done .

Having a mastectomy does take away the worry that there could be more cells left behind.

I know it’s hard when faced with such tough decisions.

I wish you luck with your journey xx

Hiya

i’m not sure I can offer any meaningful advice but I can tell you my thoughts
I was diagnosed with ILC on 20/08.I was told that it was 2.5cm and was only offered a lumpectomy with sentinel node biopsy although I did ask about a mastectomy I was totally dismissed but when the results came back there were no clear margins so I was then booked in for a mastectomy.

8 days on from the mastectomy I have  today been told that it was a good job that I had a mastectomy as it turned out to be multi focal and they would have never known.It did not show up on any scans.

Right now I’m thanking my lucky stars.

In my opinion a lumpectomy is a much easier surgery to recover from physically and psychologically.As I had originally requested a mastectomy I was not prepared for the mental health impact of having one done .

Having a mastectomy does take away the worry that there could be more cells left behind.

I know it’s hard when faced with such tough decisions.

I wish you luck with your journey xx

Hi Lynnie,

I was diagnosed with invasive lobular cancer in June.

been on letrozole since July to shrink it so was able to go for wide excision 3 weeks ago.

wasn’t ready for mastectomy unless absolutely necessary,

Tumour removed and basically fat rejiggled about to fill in the space.

get results on Thursday so see if margins clear enough.

if not then mastectomy it will be and I’ll accept that as I’d tried other options.

good luck with your decision.

take care x

I have just received the results of my biopsy and the news was not good, I have an aggressive grade 3 cancer.  The options are to have an MRI scan to see if there are other cancerous cells in the breast, then await a date for a lumpectomy, followed by radio therapy for two weeks, and then hormone therapy for the next ten years.  There was no talk of a mastectomy.

I decided to go for a mastectomy and hormone therapy.  The consultant said that many women go down this route, and he gave me the option of changing my mind.  The surgery is booked for 11th January.

My decision was based on 1) my age - 73 and 2) supposing they don’t see all the possible cancerous cells in the MRI,  I’m then left with going through all this again.  I also felt that the MRI would not show up pre-cancerous cells.

This is obviously not something anyone wants to face, but I’m remaining optimistic albeit dreading the surgery and recovery.